Tag Archive: absolute neutrophil count

Neutropenic Fever-Misdiagnosis During Chemotherapy Tale of Survival

Febrile Neutropenia more commonly referred to as Neutropenic Fever can be deadly when untreated.  Here is a first hand account where misdiagnosis in a patient also undergoing chemotherapy for Multiple Myeloma almost cost him his life due to the fever leading to neutropenic sepsis.


Classic symptoms of Neutropenic Fever were present, originally with a temperature of 101 Fahrenheit along with chills and weakness.  This patient, who was also awaiting a stem cell transplant to save his life, went to the emergency room where it was written off as a flu bug with no check for a low white blood cell count taken or absolute neutrophil count calculated despite the chemotherapy treatment.


This is an example why everyone, especially those susceptible to neutropenia either due to low absolute neutrophil count, active infection, or undergoing chemotherapy need to ensure they are aware of the symptoms of Febrile Neutropenia – Neutropenic Fever as the window for treating this is small and imperative that it be caught and treatment begin immediately prior to neutropenic sepsis setting in.  Had he been informed and insisted for his absolute neutrophil count or (anc) calculated to determine his neutrophil count rather than do what most of us often do; assume the medical facility and staff will know to check everything that requires checking, he would not have been re-admitted within hours with his temperature risen to 105 degrees and on the brink of death.

If you would like to know more on this topic, please read our related article to learn more about the detection, symptoms and treatment of Neutropenic Fever




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Calculating Absolute Neutrophil Count Example Video

Here is a video example of how your absolute neutrophil count or anc is calculated to further understand the method of calculation of neutrophils active in your complete blood count.  Note that there are two formulas discussed; one with polys and bands and one without to determine your ANC count.  The ANC calculator available on this site is calculated using polys and bands as demonstrated in this method.  Both methods will give an accurate anc calculation.




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Absolute Neutrophil Count: An Overview of it All

Overview- Absolute Neutrophil Count or (ANC) Count for neutrophil cells is the determining factor for the treatment of various diseases as it helps to ascertain the immunity levels in a person’s body. This count is a crucial consideration for serious treatment procedures such as transplants and radiation therapies.

To define the Absolute Neutrophil Count or ANC, it is important to know that neutrophils are the white blood cells that help in the digestion of micro-organisms such as bacteria that enter the body. Therefore, these cells are imperative for the well-being of the immune system of the human body. The ANC Count or the Absolute Count of neutrophils is the amount of WBCs that are present in the blood.

In a normal human body, this count is 1500 cells per microliter (cpm) of blood. In case this count is low, i.e. in the range between 500-1000, the person is termed as neutropenic. Such a person is considered prone to infections as there is a lack of infection fighting cells in the body. In cases where this count is lower than 500, the person is termed to be suffering from Severe Chronic Neutropenia. Such a person is counted to be highly vulnerable to serious infections and diseases such as febrile neutropenia or neutropenic fever. Such people are also required to take several precautions against infections by monitoring the cleanliness of their surroundings and their bodies.

Understanding ANC:

  • ANC Count Calculation: The neutrophil count in the body is determined by calculating the combined percentage of the developed and the young neutrophils cells. The formula for determining count is [(%neutrophil/100+%bands/100)x(WBC/1000)] = [(%neutrophil+%bands)x(WBC/100,000)]
  • The unit of ANC measurement: The count of neutrophils in the body is measured in micro-liters which equals a cubic millimeter.
  • The important ANC counts and their implications: The normal count for ANC is between 1500 to 1800 cells per cubic millimeter of blood. The situation where the count is lower than 1500 cells per cubic millimeter and is above 1000 cells per cubic millimeter is termed as Mild Neutropenia. In cases where the count is above 500 cells per cubic millimeter and below 1000 cells per cubic millimeter, the situation is termed as moderate neutropenia. When this count drops below 500 cells per cubic millimeter, the case is termed as severe neutropenia and this is the time when the person concerned deserves intense care and medical attention. The cases of moderate and mild neutropenia are susceptible to infections, but are still not much in danger; and this is a situation which can be handled easily with medication and care.
  • Causes for high ANC: Some of the possible reasons for ANC can be stress, infections, physical over exertion, use of corticosteroids or lithium carbonate, as well as nervousness and anxiety.
  • The importance of ANC: It is important to be aware of one’s Absolute Neutrophil Count as it determines the intensity to which one is susceptible to infections. This count is mostly calculated for people who are to undergo treatment for cancer or have disorders such as Neupogen, Granocyte or Neulasta. This count is also essential in cases where a person is to undergo radiation therapy of any kind, chemotherapy, bone marrow or stem cell transplant so that the health of one’s immune system can be ensured before taking the treatment process further.


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ANC Calculator: Knowledge of Your ANC Count Can Save Your Life

Overview: ANC Calculator is used to measure the neutrophil count in white blood cells. Learn more about it in the article as well as use our onsite version and watch our example video on how it is calculated

A complete blood count offers detailed information including three cell types – platelets, red blood cells, and white blood cells. These cells are basically found in the bone marrow in few areas of the body such as the skull, ribs, sternum, backbone, and so on. Each type has a separate function and if the count decreases, it can be very harmful for the individual and often leads to failure of immune system. To prevent such circumstances, one must measure the blood counts via an ANC Calculator to know precisely what one’s absolute neutrophil count or ANC count is.

Blood Cells – Types and Characteristic
Before understanding what the ANC does, it is imperative to know what these blood cells are. As mentioned before there are three types;
• Red Blood Cells or RBC is what carries oxygen through the system. Containing hemoglobin, these cells are also responsible for removing waste items from the tissues of the body.
• White Blood Cells or WBC is what helps the body fight diseases and infections. For a strong immune system the WBC count should fall between 3.3 and 8.7 K/ul.
• Platelets are responsible for blood clotting. They help in stopping the blood flow after injury by clotting the blood.

White Blood Cells and Neutrophils
White Blood Cells can be further divided into five types which travel across the body destroying infection in the body – neutrophils, basophils, eosinophils, lymphocytes, and monocytes. The one which dominates is Neutrophils which makes up 56% of WBCs in the body and is responsible for attacking bacteria and other infection inside the body, making you strong and infection resistant. Neutrophils can be further divided into two types – polys which refer to fully-grown neutrophils and bands which refer to young polys.

To maintain a healthy body one must maintain the level of neutrophils in the body. Monitoring it is necessary and this is where ANC comes to rescue.

What is ANC?
ANC or absolute neutrophil count measures the total number of neutrophils in the blood. Also called the absolute granulocyte count or AGC, the calculator follows a simple formula where the total number of WBC is measured along with the polys and bands’ percentage. Once that is measured, the number of WBC is multiplied by the percentage.

Instances when the neutrophil count is low, the risk of disease increases and this condition is called neutropenia. Next time you notice that the ANC count is low, look for symptoms of neutropenia such as high fever (known as neutropenic fever), sweating, shaking chills, body pain, general tiredness, frequent urination, shortness of breath, redness of skin, and so on.

If you are neutropenic, you can take care by doing the following:
• Wash hands as frequently as possible
• Check your body temperature at least once a day. Take note of any fluctuations and notify your doctor immediately. Do not consume any medicine for the fever without medical consultation.


• Shower Daily. Use unscented lotion after bathing to avoid the skin from drying and cracking.

You can always fight a disease if you know that you suffer from it. This is where an ANC Calculator comes in handy. So, if you notice that you suffer from one or more symptoms of Neutropenia then consult a doctor to gauge the ANC count and ideally raise the neutrophil count in your blood.

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Neutropenic Fever- A Terrifying But Treatable Disease

Overview: Neutropenic fever also know as febrile neutropenia occurs due to blood infection that can be caused from a chemotherapy complication, renal failure, skin wounds, secondary infection or HIV/AIDS. Its classical symptoms are fever, sepsis, cardiac dysfunction and low white blood cell and neutrophil count. The best way to treat neutropenia is by the empiric antibiotic method in which the treatment duration lasts 3 weeks.

Neutropenic fever or febrile neutropenia is usually seen as a chemotherapy complication or occurs due to renal failure. It’s underlying cause is blood infection that occurs when white blood cells get flooded with toxins. Patients suffering from this fever need urgent treatment, delay of which may lead to death.

Neutropenic Fever- Causes

Other than chemotherapy and renal failure, neutropenia can also be caused due to foreign objects such as a wood splinter or thorn entering the skin, minor abrasions or punctures that allow fungi or bacteria to seep into the body, infections such as typhoid or meningitis that lead to neutropenia as a secondary infection and HIV/AIDS that suppresses the body’s immunity thus making it more susceptible to infection.


Neutropenic Fever- Symptoms and Treatment

The classical symptom of this disease is fever that occurs because the body’s immune system combats infection or sepsis. Neutropenic Sepsis can either be mild in nature that can cause abnormalities in vital signs such as heart rate or severe which might lead to organ dysfunction and can even cause death.

Another typical symptom is that of a low white blood cell count that is observed particularly in those patients undergoing chemotherapy as it decreases the ability of the bone marrow to generate these infection-fighting cells. In such patients, the absolute neutrophil count is found to be less than 0.5 x 109/L. This count along with a body temperature of >100.4oF is indicative of the presence of neutropenia. Patients are also screened for blood pressure and lactic acid levels and if found to be hypertensive or with > 4 lactate levels are put in ICU for immediate treatment of antibiotics.

As a first step towards treating patients, they are generally put on wide spectrum of antibiotics to control spread of infection. In order to be most effective treatment must begin within one hour after confirming the presence of the disease. During this phase, blood and microbiological tests are conducted to target the treatment.

One method to treat neutropenia is by using the empiric antibiotic method. This method involves the use of antibiotics that have been tailored as per the results of microbial cultures and radiography. This treatment is continued until the neutrophil count exceeds 0.5 x 109/L. Such patients continue this therapy for a maximum of 3 weeks or until the fever subsides and might be switched to oral therapy depending on their recovery rate.

In patients in whom the fever does not reduce despite empirical antibiotic therapy other sources of infection are looked into such as secondary, non-bacterial and/or medication reaction infections which are treated by changing the course of antibiotics and by including an antifungal treatment course. For patients who have been severely affected by neutropenic sepsis, doctors typically recommend that the antibiotic course be continued even after the patient has recovered in order to prevent relapse.

Patients suffering from neutropenic fever - febrile neutropenia can recover completely provided they are given timely treatment. Hence, persistent fever along with low blood pressure symptoms should not be disregarded and medical attention sought immediately.


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ANC Calculator, Calculate Your Neutrophil Count


Absolute Neutrophil Count, ANC Calculator.  Input your data in fields below to calculate your ANC.  Below is the formula used for calculating your ANC.








Formula Used:

ANC (cells/mm3) = [(Neutrophil % + Band Cells %) x Total WBC] / 100


ANC – Absolute Neutrophil Count
WBC – White Blood Cells

As Stated Throughout our website if ANC Count = less than 500 the patient is at high risk for infection from any number of pathogens

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6 Things to Know About Absolute Neutrophil Count


ANC, absolute neutrophil count,is the numeral calculation of neutrophil granulocytes (these are polymorphonuclear cells and are also identified as PMN’s, polys, granulocytes, segmented neutrophils or segs) that exist in the blood. Approximately between fifty and seventy percent of the body’s entire amount of white blood cells are Neutrophil. They are white blood cells that help in fighting against infection and diseases.

The ANC is evaluated from the calculation of the entire amount of the white blood cell (WBC), generally found on the joined percentage of developed neutrophils and bands that are young neutrophils. Here is the formula used for majority of any anc calculator available on web including this site.

Calculation of Absolute neutrophil count

ANC is calculated by using the following formula:

ANC = [(%neutrophil/100 + %bands/100) x (WBC/1000)] or ANC = [(%neutrophil + %bands) x (WBC/100,000)]

Here, we suppose that the CBC as of which we are analyzing the WBC is in cells/mL. This makes the above thousand an alterable factor to alter to cells/µL.

Unit of ANC

The unit of ANC is cells per micro-liter of blood. Its abbreviation is µL. A micro-liter is equivalent to one cubic millimeter.

Different values of ANC

Here are various values of neutrophil granulocytes in the blood:

  • Normal value: 1500 cells/mm3.
  • Mild neutropenia: 1000 – <1500/mm3.
  • Moderate neutropenia: 500 – <1000/mm3.
  • Severe neutropenia: < 500/mm3.

Medical Implication of ANC

  • Absolute neutrophil count (ANC) of 1000-1800: In this range, the threat of infection is subtle. Majority of the patients with this range undergo chemotherapy.
  • Absolute neutrophil count (ANC) of 500-1000: This is a state of mild neutropenia and brings out a fair chance of infection.
  • Absolute neutrophil count (ANC) of less than 500:  This is a condition of severe neutropenia. It results in a high threat of infection as well febrile neutropenia also known as neutropenic fever.
  • A decreased amount of WBC is known as leukopenia.

Possible Reasons of High ANC

Below are a few of the possible reasons that result in a high ANC:

  • Stress
  • Infections
  • Corticosteroids. They are normally set down to fight inflammation
  • Lithium carbonate. They are given to treat particular psychiatric states.
  • Tiring physical exercise
  • Nervousness
  • Anxiety

The importance of ANC:

Absolute neutrophil count is imperative because its calculation helps measure the threat of infection your body is susceptible to. It shows if you must be under treatment for Neupogen, Neulasta, or Granocyte. Moreover, if you’re going through the treatment of radiation, chemotherapy,  a bone marrow or stem cell transplant, it is utilized to calculate the condition and health of your overall immune system.

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What is Absolute Neutrophil Count?


You might be aware of the fact that White Blood Cells (WBCs) provide our body with a natural safeguard and are the building blocks of our immune systems. They protect the body from infections by traveling quickly to the affected area and getting rid of bacteria. Neutrophils are a category of WBCs that are filled with minuscule granules that contain enzymes that digest microorganisms like bacteria. They are also called granulocytes. Blood of mammals has a greater percentage of these WBCs and fight body infections. The amount of WBCs in our blood that are neutrophils, therefore results in the Absolute Neutrophil Count (ANC) or the Absolute Granulocytes Count (AGC).

The Levels of Absolute Neutrophil Count

A normal ANC is over 1500 cpm (cpm is a unit that equals cells per microliter of blood). An ANC of 500 to 1000 is considered neutropenic, which increases the probability of the individual getting infections since they have less number of infection-fighting cells. A person having ANC too below to 500 is known to have Severe Chronic Neutropenia, which means that the patient is very vulnerable to getting serious infections including febrile neutropenia or neutropenic fever.

Some Precautions For People With Low ANC

If someone has low ANC count, then there are several things that need to be taken care of as well as continued monitoring of levels using an anc calculator in addition to taking great caution regarding certain things.

  • Cleanliness – The patient with low ANC should be very hygiene-conscious. They need to care to sanitize their hands following every visit to the toilet, or after coughing, sneezing or anything else that might expose them to bacteria. They also need to make it a habit to wash hands before eating and also to just keep themselves clean all the time. Bathe regularly, or shower according to preference. They should also prevent skin from getting dry or cracked, so they should moisturize their skin as often as required.
  • Dental Care – Individuals with a low ANC should keep their mouth clean and rinse often, especially after meals. They should keep lips lubricated to keep them from getting chapped. They should not floss if the ANC is less than 500. Also, they should make sure to consult their doctor before having dental work done.
  • General Precautions – People with low ANC should prevent anything that exposes them to illnesses, multitude of people or dirt. Should they get cut, they should sanitize the area right away and put bandage to avoid infections.  They should also avoid getting vaccinations without the doctor’s recommendation. Women with low Absolute Neutrophil Count should also be regular about taking birth-control as suggested by their doctors. Watching for signs of febrile neutropenia (neutropenic fever) should also be considered and any signs of fever coupled with low anc need to be reported to treating Physician immediately prior to any further onset of neutropenia or neutropenic fever.

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All You Need To Know About Absolute Neutrophil Count

Absolute Neutrophil Count (ANC) calculates the number of neutrophils present in a human being’s blood, which are the most common type of white-blood cells found in all mammals. It determines the amount of white-blood cells (neutrophils) that are an important component of our immune system, and are found in our bodies to fight-off infections and fever.

Clinical Significance

Knowing your Absolute Neutrophil Count is helpful in gauging the risk of infection that you might be vulnerable to, and also to determine whether you are fit to undergo specific treatments such as chemotherapy, radiation and bone marrow transplant etc. An ANC Count above 1500 cells per µL is considered normal, while anything below that increases the risk depending on the range.

If your ANC Count falls below 500 cells/µL, you are significantly exposed to risk of infection as well as Neutropenia, which is a condition characterized by unusually low numbers of neutrophils or white-blood cells in your system, and might even prove to be life-threatening in some cases often due to  Febrile Neutropenia or neutropenic fever. The severity of Neutropenia in such a case again depends on the range of your Absolute Neutrophil Count, i.e. an ANC of 1000-1500 cells/µL results in mild neutropenia, while a range of 500-1000 and below 500 cells/µL denotes mid and severe neutropenia, respectively.

Depending on the severity of neutropenia based on your ANC, your doctor might advise certain precautions such as avoiding crowded places, excessive travel, or even complete isolation in case of severe neutropenia.

Measurement of ANC

An ANC calculator reading is measured in microliters (µL= 1 mm3) by simply multiplying your total white blood count by the total number of neutrophils (%segmented neutrophils + %bands) x 10. In this formula, the segmented neutrophils are the ones that are fully mature, while the bands are those that are almost mature. Slightly different variations of this formula are also used, depending on the units of measurement (µL or 103/µL) or scales of percentages etc.; however the underlying principle is the same across all of them. An ANC calculator can also be used to determine the figure based on similar equations to measure Absolute Neutrophil Count.

Certain differences might arise among the results of different lab reports; in fact, each lab might have its own techniques which might show completely different results from a report obtained from another lab depending upon specific variables used to make up formula for anc calculations as . There are several factors that account for such differences, for example different units used to report WBC count including microliters, milliliters or cubic milliliters; variations in the names used for the counts, e.g. neutrophils is sometimes used for the total number of neutrophils, while at other times it might refer to segmented ones only. Therefore, it is always advisable to ask the doctor/lab assistant about the reporting conventions of your Absolute Neutrophil Count report and make conversions or different anc calculator if necessary.

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Why You Should Care About Your Absolute Neutrophil Count

Absolute neutrophil count sounds like a daunting lesson in biology. But really it is one topic that every person needs to at the very least be acquainted with these days. Neutrophil is a type of white blood cell that is integral to our natural defense system which fights against infections and virus invasion. The ANC is basically a calculation of how many active neutrophil granulocytes you currently have in your blood stream, fighting on your behalf. Seeing as these cells are your main protection against diseases and illnesses, it would do well to know more about them.

How to calculate this count?

Seeing as there happens to be different types of white blood cells floating about in your blood stream, there is a special method and equation employed to get your absolute neutrophil count. First off, a sample of your blood is drawn which is quite an obvious step. Next, understand that the ANC is not and cannot be directly calculated despite many anc calculators in existence they will vary widely depending on formula used as well as medical interpretation of data in your blood work. The count is the result of multiplying the total white blood cell count of the patient by the percentage of neutrophils in a differential white blood cell count.

Why is it important to be aware?

This information is important because one must be aware of their body and the state of its natural defense mechanisms. Should the ANC count come out as lower than normal, you may have a condition called Neutropenia. The means, you will be prone to falling ill more often than the average person and be likely to contract any viral infection you come in contact with. This can be quite dangerous obviously seeing as many of these diseases are quite serious. Falling prone to Febrile Neutropenia or Neutropenic fever is commonly a very serious and often life threatening risk of Neutropenia.

The absolute neutrophil count also becomes a crucial element in the treatment of cancer and chemotherapy, in which instance the ANC is manipulated and dropped intentionally to accommodate the treatment. For this, the process needs to be carefully monitored and use of an anc calculator often throughout treatment so that the count does not drop beyond what is necessary. Finally, if your absolute neutrophil count is higher than normal, it is possible that your body would reject anything “alien”, such as a transplant. This is also problematic in cases where one needs an organ transplant or a blood transfusion as the risk of rejection becomes higher.

Most good health care providers and hospitals are equipped to perform this test and it would be wise to remember that this is general information. One should always consult a professional healthcare provider.

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